Commercial Credit Application

To Open a new account with Countryside Energy please complete the online Commercial Credit Application and then click submit to send directly to the Countryside Energy customer service team. You also have the option of printing the completed form, signing & then mailing to the Countryside Energy office at 8794 NYS RT. 415, Campbell, NY 14821.

Request Commercial Propane Credit Today:

I, the undersigned, hereby certify that all statements made on this application are true and correct. Further, I agree to the following terms and conditions:

1. The undersigned authorizes Countryside Energy Services, LLC to conduct any credit investigations necessary to establish and open line of credit for the above named applicant. It is also acknowledges and agreed that any and all accounts receivable information may be reported by the company to various commercial and consumer credit agencies.
2. To pay the service charge for late payment as stated on each invoice or statement.
3. If this account is placed for collection, I/we agree to pay all collection costs, including reasonable attorney's fees.
4. I/we agree that we must notify the company, in writing and by certified mail, of any changes in ownership, business name change or a change in the structure of the business under which credit has been established.